Physical Exam

Question 1

T or F: resonance in percussion is abnormal

Answer 1

False: normal

–> dull or hyperresonant sounds

Question 2

What does a dull resonance sound mean?

Answer 2

Pleural effusion

Consolidation (pneumonia) [Pulmonary edema]

Question 3

What does a hyper resonance sound mean?

Answer 3

Air trapped

–> pneumothorax, emphysema

Question 4

What are the characteristic of normal breath sounds?

Answer 4

vesicular

Question 5

T or F: a decreased breath sound over a location usually means the pathology is also located there

Answer 5

T

Question 6

What are some adventitious (abnormal) breath sounds?

Answer 6

rales
wheezes
rhonchi
bronchiol breath sounds
stridor

Question 7

What is another word for rales?

Answer 7

crackles

Question 8

How does the crackle sound occur?

Answer 8

Small airways pop open after collapse

Question 9

When do crackles usually occur?

Answer 9

Early inspiratory, late inspiratory, expiratory [intrathoracic]

Question 10

What are common causes of rales?

Answer 10

pulmonary edema (at the base of the lung due to gravity)
pneumonia at affected lobe
interstitial fibrosis (due to stickyness)

Question 11

what causes wheezes?

Answer 11

air passing through narrowed bronchi

Question 12

when do wheezes usually happen?

Answer 12

usually expiratory but can be both inspiratory and expiratory

Question 13

common causes of wheezes?

Answer 13

asthma
chronic bronchitis (less common), tumour obstructing (localized wheeze)

Question 14

What causes rhonchi?

Answer 14

secretions in large airways

Question 15

common in?

Answer 15

COPD

Question 16

What is the characteristic of a rhonchi?

Answer 16

coarse breath sound

Question 17

what are bronchial breath sounds?

Answer 17

high-pitched

Question 18

T or F: individual with bronchial sounds have a longer expiratory phase

Answer 18

T

Question 19

Bronchial breath sounds are seen in what patients?

Answer 19

Pneumonia with consolidation

Question 20

What is stridor?

Answer 20

A wheeze that is primarily INSPIRATORY but EXTRATHORACIC (contrary to crackles/rales)

Question 21

Where is the stridor more prominent?

Answer 21

neck

Question 22

What does stridor indicate?

Answer 22

partial obstruction of larynx or trachea

Question 23

What are some causes of stridor

Answer 23

Laryngotracheatis
Epiglottitis
Retropharyngeal Abscess
Diphteria

Question 24

What is pectoriloquy?

Answer 24

sounds over the chest when patient is speaking (usually it should be muted and unclear) -> in this case it is loud and clear

Question 25

What is a whispered pectoriloquy?

Answer 25

whispered 99-99-99 comes as clear instead of muffled

Question 26

What is a egophony?

Answer 26

EEEE sounds like Aaaaay

Question 27

What is indicated pectoriloquy?

Answer 27

Fluid in lung –> effusion, consolidation

Question 28

What is the fremitus technique?

Answer 28

when hands are placed at the back and patient says 99

Question 29

What is fremitus?

Answer 29

vibrations

Question 30

When would expect increased fremitus?

Answer 30

lobar pneumonia

Question 31

In what conditions would a lower fremitus occur?

Answer 31

pleural effusion, pneumothorax, atelectasis

Question 32

What causes nail clubbing?

Answer 32

Bronchiectasis
CF
Lung tumor
PF
cyanotic congenital heart disease